Planned Parenthood : Survey - PPGT Volunteer Interest Form

Thank you for your interest in volunteering with Planned Parenthood. Completing this form will help us identify where your support is needed the most.

We require that our volunteers attend a volunteer orientation and HIPAA training. Depending on the position, further training may be required and commitment requirements may vary. Please note that we may not have immediate opportunities available, but we will contact you as soon as a position becomes available in your area of interest.

If you have any questions, please email volunteers@ppgt.org.

Please provide us with your most current, accurate contact information.

If you have previously registered, please login here to prepopulate your information.

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Name:

Title	First Required	Middle Required	Last Required

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Email: Required

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Street 1: Required

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City/State/ZIP:

City Required	State Required	ZIP Required

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Phone Number: Required

Yes, I would like to receive e-mail from Planned Parenthood of Greater Texas Action Network

Yes, I would like to receive postal mail from Planned Parenthood of Greater Texas Action Network

Remember me.

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Question - Required - Why do you want to volunteer with Planned Parenthood?

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Question - Required - Have you ever volunteered with us (or another Planned Parenthood organization) before?

Question - Not Required - If yes, please list dates, supervisor, position, and duties.

Question - Not Required - Why did you leave?

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Question - Required - Have you volunteered with another organization in the past?

Question - Not Required - If you have volunteered with other organizations, please list dates, positions, supervisors and duties.

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Question - Required - What do you want to get out of your volunteer experience?
Please make between 1 and 3 selections from the choices below.

	Better knowledge of reproductive rights
	Experience advocating for issues
	A chance to help the community
	To broaden your social network, or to make friends
	Other

Question - Not Required - If other, please specify:

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - What types of volunteer activities are you interested in?
Please make between 1 and 3 selections from the choices below.

	Volunteer Nights (ex: miscellaneous projects)
	Administration/Clerical (ex: filing, creating packets)
	Community Outreach (ex: staffing booths at community events)
	Health Center Advocacy (ex: voter registration at health centers)
	Public Affairs/Government (ex: contacting legislators, Lobby Days, collecting petitions)
	Development/Fundraising (ex: assisting with mailers, staffing fundraising events)
	Leadership (ex: facilitating volunteer attendance at community events)
	Young professionals networking group

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Question - Required - Where would you like to volunteer?
Please make at least 1 selection from the choices below.

	Austin
	Waco
	Dallas
	Fort Worth
	Other - Please specify

Question - Not Required - If other, please specify:

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - When can you volunteer?
Please make at least 1 selection from the choices below.

	Weekdays during regular business hours
	Weekdays during the evenings
	Weekends
	I can volunteer on an as-needed basis

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Question - Required - How often can you volunteer?
Please make at least 1 selection from the choices below.

	Two hours a week
	More than two hours a week
	Less than two hours a week
	Once a month
	Twice a month
	Occasionally on special projects
	Other

Question - Not Required - If other, please specify:

(Maximum response 255 chars, approx. 5 rows of text)

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I can commit to this on a regular basis for:

(Select one of the available choices or enter a different value.)
Question - Required -

Question - Not Required - Do you have any other information you'd like to share?